Healthcare Provider Details

I. General information

NPI: 1386998664
Provider Name (Legal Business Name): BAY VIEW REHABILITATION HOSPITAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/07/2012
Last Update Date: 11/19/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

516 WILLOW ST
ALAMEDA CA
94501-6132
US

IV. Provider business mailing address

530 N PUENTE ST
BREA CA
92821-2804
US

V. Phone/Fax

Practice location:
  • Phone: 310-266-1080
  • Fax: 714-256-2003
Mailing address:
  • Phone: 310-266-1080
  • Fax: 714-256-2003

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number StateCA

VIII. Authorized Official

Name: DAVID JOHNSON
Title or Position: CEO
Credential:
Phone: 310-266-1080